38 Chapter 2
pairs that differ by one sound. The pictures demonstrated the deficient phonological pro cess. For
example, she was shown a series of word pairs with and without final consonant deletion, such
as me– meet and car– cart. China learned not to delete final syllables by attending to the minimal
contrasts and the associated phonological pro cesses. Other phonological pro cesses were addressed
in a similar manner. China ultimately learned age- appropriate phonology, and her speech became
much more intelligible. During “show and tell,” China brought Rosie the pug to class and was able
to talk at length about her unusual appearance and comical antics.
Case Study 2-4: A /w/ for /r/ Substitution in a Fourth Grader
As an itinerant speech- language pathologist, Wendy enjoys her job and particularly looks for-
ward to Friday after noons. It is true that at first, Wendy did not want a job that required traveling
from one school to another. She thought she wanted to serve only one school; to have one office
and one therapy suite; and to interact with the same teachers, support personnel, and administra-
tors. She thought she wanted to see only the children in one school. Nevertheless, after a few weeks
on her new job, she was pleasantly surprised to find that being itinerant was a great way to earn a
living. On Mondays, Wednesdays, and Fridays, she goes to a small rural school to see her favorite
client: a little boy named Geraldo.
What is so enjoyable about her interaction with Geraldo is not that he is improving rapidly,
although he is. It is that Geraldo willingly shares his fourth- grade experiences with Wendy. She
particularly likes to hear about tall Trudy, who mercilessly teases him. Geraldo freely talks about
his confused and mixed feelings about her. This /w/ for /r/ substitution brings tears of laughter to
Wendy’s eyes. Nevertheless, she knows that although a /w/ for /r/ substitution may be appealing in
a fourth grader, it is a liability in a teenager or an adult.
Liquid gliding is a common phonological disorder, and some children have several glide sub-
stitutions. (Liquid is a generic term for the /r/ and /l/ speech sounds). For example, individuals
may substitute /r/ for /w/, /l/ for /w/, or other such combinations. When children have more than
one liquid gliding substitution, Wendy prefers to treat it as a phonology disorder and to address
the errors and the under lying phonological pro cesses. However, as with Geraldo, when only the
/w/ for /r/ substitution exists, she prefers to treat it as a functional articulation disorder and uses
the traditional therapy that has worked so well historically. There is overlap in the phonological
and traditional approaches to /w/ for /r/ substitutions, but Wendy has found that the traditional
approach works best when these substitutions occur in isolation.
In this approach, Wendy first addresses Geraldo’s auditory perception. She knows that children
who substitute one glide for another often do not perceive differences auditorially between the two
phonemes. Acoustically, the /w/ is similar to the /r/ phoneme, much more so than it is to the /s/
or /dʒ/ phoneme, for example. Wendy first has Geraldo listen as she says words from a list. Some
words have his phoneme, which they have agreed to call the “r”abbit sound. As she reads from the
word list, Geraldo claps his hands each time he perceives his phoneme. Wendy praises him for his
work. Then she has Geraldo perceive the differences between the /r/ phoneme within syllables,
telling him to identify it in vari ous positions. After Geraldo has developed this auditory percep-
tual skill, Wendy teaches him to perceive the /r/ phoneme in words. She reads a list of words with
the /r/ phoneme in the initial position, and Geraldo taps the clinical table when the phoneme is
detected. Once he has mastered this auditory perception, Wendy has him do similar activities with
words having the /r/ in the final and medial positions. She also has Geraldo play games in which
he distinguishes the /w/ from the /r/ sound.
After the auditory perceptual exercises, Wendy begins the production phase of the traditional
articulation therapy for Geraldo’s /w/ for /r/ substitution. During the evaluation, stimulability testing
found that Geraldo is unable to produce the correct /r/ phoneme by imitation. In addition, Wendy
conducts deep testing, in which the phonetic contexts of his misarticulation are altered and the